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301 test 2 Flashcards

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1
Q

what can nutrition effect?

A

tissue integrity, sensory perception, and elimination

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2
Q

what can effect nutrition

A

hormonal regulation, elimination, glucose regulation, and sensory perception

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3
Q

people with burns are at risk for

A

hypovolemic shock

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4
Q

purpose of nutritional assessment

A

identify individuals who are malnourished/dehydrated or are at risk for development of calorie and liquid malnourishment.

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5
Q

what lab do we look at to assess nutrition

A

total protein= prealbumin, albumin, and globulin

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6
Q

normal albumin

A

3.5-5 gdL

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7
Q

what does albumin lab measure

A

circulating protein. can be impacted by fluid status and liver function

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8
Q

how long will it take to see fluctuations of albumin

A

3-4 weeks

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9
Q

prealbumin normal levels

A

15-36 mg/dL

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10
Q

what does prealbumin reflect

A

protein and calorie intake for the previous 2-3 days

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11
Q

normal levels of blood glucose

A

70-105 mg/dL

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12
Q

what does blood glucose reflect

A

carbohydrate metabolism

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13
Q

what can hgb/hct indicate in labs

A

can indicate anemia caused by low iron, folate and vitamin B12

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14
Q

what does the lipid profile show

A

reflects lipid metabolism

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15
Q

what can BUN/creatine ratio and urine specific gravity be used for?

A

to determine hydration status

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16
Q

normal range of BUN/ creatine ratio

A

20:1

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17
Q

Hemoglobin A1C

A

glucose levels over long period of time

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18
Q

what topics are included in present health history for nutrition assessment

A

chronic illness, medications, weight changes, food intolerances, street drugs or alcohol, problems obtaining eating food, weight concerns

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19
Q

what do alcohol and street drugs do to your nutrition

A

decrease nutritional absorption

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20
Q

what measures can be taken to correct weight concerns

A

diet and exercise modifications and surgery

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21
Q

methods of obtaining a diet history

A

24 hour recall, typical food intake, food diary, comprehensive diet history

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22
Q

nutritional exam includes

A

anthropometric measurements, inspections of skin, hair, and nails, inspections of eyes, inspection and palpation of the extremities bilaterally

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23
Q

BMI

A

body mass index, estimate of total body fat

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24
Q

triceps skin fold

A

evaluate subcutaneous fat stores

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25
Q

mid-arm muscle circumference

A

evaluate muscle reserve

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26
Q

how do you calculate BMI with inches and pounds

A

((weight in pounds/(height in inches x height inches)) X 703

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27
Q

BMI underweight

A

below 18.5

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28
Q

BMI normal

A

18.5-24.9

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29
Q

BMI overweight

A

25-29.9

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30
Q

BMI obesity class 1

A

30-34.9

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31
Q

BMI obesity class 2

A

35-39.9

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32
Q

BMI morbid obesity

A

40 and greater

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33
Q

BMI chart does not work on individuals who are

A

below 5 feet

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34
Q

BMI does not differentiate between

A

fat and muscle tissue

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35
Q

what happens with muscle mass in elderly

A

they tend to lose it

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36
Q

what should you add to BMI to increase predictability for health risk

A

waist circumference

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37
Q

calculate percent change in weight

A

current body weight/usual body weight X 100

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38
Q

calculate waist to hip ratio

A

pear shape vs apple shape

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39
Q

DBW

A

desirable body weight

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40
Q

normal DBW

A

(desirable body weight) normal is 90-110%

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41
Q

what happens with nutrition as you get older

A

physical limitations, decreased taste and appetite, muscle tone and mass decrease, loss of subcutaneous fat, become more salt sensitive, fat is redistributed

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42
Q

assessing hydration status

A

weight, skin turgor, pitting edema, skin moisture, tongue,lung sounds, blood pressure, urine output

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43
Q

malnutrition can be confused with what other diseases

A

anemia, hyper or hypothyroidism, hepatic disease, alcoholism, cancer, depression

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44
Q

obesity related conditions

A

obesity related conditions include heart disease, CVA, DM type 2 and certain types of cancer

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45
Q

what portion of America is obese

A

1/3

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46
Q

estimated annual cost of medical cost towards obesity

A

147 billion

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47
Q

obesity risk factors

A

sedentary lifestyle, high fat diet, genetics, ethnicity/race, female, age

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48
Q

reasons for undernutrition

A

acute illness, chronic disease, extreme age, alcohol abuse, depression, limited knowledge, physical inability, eating disorder, poverty, lifestyle

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49
Q

enteral feeding

A

tube feeding provided through a tube inserted into the nose to stomach, small-intestine, or gastrostomy

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50
Q

parenteral nutrition

A

when GI tract can no longer be used for digestion. can be IV fluids with dextrose or total parenteral nutrition

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51
Q

parenteral nutrition has high risk for

A

infection

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52
Q

PEG

A

percutaneous endoscopic gastronomy tubes

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53
Q

signs of fluid overload

A

weight gain, pitting edema, visible neck veins, crackling lung sounds, elevated pulse rate and blood pressure, SOB

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54
Q

new food guidance system in US

A

choose my plate includes 5 food groups. make half your plate fruits and vegetables and half your plate grains and protein

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55
Q

peritoneum

A

serous membrane forming protective cover of the abdominal cavity

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56
Q

peritoneum divided into what 2 layers

A

parietal and visceral

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57
Q

peritoneal cavity

A

space between the parietal and visceral layers, contains small amount of serous fluid to reduce friction

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58
Q

alimentary tract

A

27 feet long. ingest, digest, absorb nutrients, electrolytes, and water, and excrete waste product

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59
Q

what parts does the alimentary tract include

A

esophagus, stomach, small intestine, and large intestine

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60
Q

esophagus ph

A

6-8

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61
Q

stomach ph

A

2-4

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62
Q

chyme

A

breakdown and conversion of carbs, proteins, and emulsified fat that is liquified

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63
Q

what does chyme consist of?

A

peptones, amino acids, fatty acids, and glycerol

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64
Q

small intestine

A

largest section of GI tract includes duodenum, jejunum, and ileum

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65
Q

large intestine

A

about 5 feet. includes cecum, colon, rectum, and anal canal

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66
Q

liver functions

A

bile production, secretion to emulsify fat, transfer bilirubin, metabolism of proteins, carbohydrates, and fats, storage of glucose in form of glycogen, production of clotting factors and fibrinogen for coagulation, synthesis of plasma proteins, detoxification of substances, and storage of minerals and vitamins

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67
Q

plasma proteins

A

albumin and globulin

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68
Q

gallbladder

A

stores bile produced by liver and ducts drain bile into duodenum

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69
Q

bile in feces cause

A

the brown color

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70
Q

pancreas

A

produces endocrine secretions and exocrine secretions

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71
Q

endocrine secretions

A

insulin, glucagon, somatostatin, and gastrin

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72
Q

exocrine secretions

A

bicarbonate, pancreatic enzymes

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73
Q

spleen

A

filters antigens from the blood, important in response to systemic infections, activation of B and T lymphocytes, stores erythrocytes and platelets

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74
Q

kidneys

A

erythropoietin secretion for erythrocyte production, regulation of fluid and electrolyte balance, RAAS, production of active vitamin D

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75
Q

kidney location

A

T 12-L3

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76
Q

moderate distention of bladder

A

300 mL

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77
Q

level of discomfort of bladder

A

450 mL

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78
Q

arteries in abdomen

A

abdominal aorta, renal artery, and iliac artery

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79
Q

Right upper quadrant

A

liver, gallbladder, pylorus, duodenum, head of pancreas, right kidney, right adrenal gland, hepatic flexure of colon, portions of ascending and transverse colon

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80
Q

left upper quadrant

A

stomach, spleen, left lobe of liver, body of pancreas, left kidney, left adrenal gland, splenic flexure of colon, and portions of transverse and descending colon

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81
Q

left lower quadrant

A

portion of descending colon, sigmoid colon, left ureter, left ovary, left spermatic cord, bladder if distended, and uterus if enlarged

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82
Q

right lower quadrant

A

cecum, appendix, right ovary, right ureter, right spermatic cord, bladder if distended, and uterus if enlarged

83
Q

GI in older adults

A

slowing of GI motility, increased likelihood of regurgitation, bacterial flora less active, increased food intolerance, decrease intestinal sphincter tone, bladder decreases in size and decrease in bladder muscle tone

84
Q

what chronic illnesses should you ask about when assessing the GI/GU

A

DMII, renal failure, liver failure, hepatitis, gallbladder disease, HTN, cancer, Crohn’s, IBS/IBD, colitis, CVA, spinal issues, benign prostate hypertrophy

85
Q

what family history should you ask about with GI/GU assessment

A

GERD, cancer of upper/lower GI, renal disease, bladder disorders and cancers, gall bladder disease

86
Q

what could black stool indicate

A

bleeding internally due to ulcer or cancer

87
Q

what could light color or white stool indicate

A

it could mean a bile duct obstruction

88
Q

what could red stool mean

A

symptom of cancer

89
Q

what could yellow stool mean

A

excess fat due to malabsorption

90
Q

what can brown urine indicate

A

increased bilirubin

91
Q

cola urine

A

rhabdomyolysis from muscle breakdown

92
Q

order of assessment for GI/GU

A

inspect, auscultate, percuss, and palpate

93
Q

urinary catheters should always be _____ than patient

A

lower

94
Q

gastro

A

stomach

95
Q

entero

A

intestine

96
Q

colo

A

large intestine

97
Q

procto

A

anus/rectum

98
Q

hepato

A

liver

99
Q

nephro

A

kidney

100
Q

cysto or vesical

A

bladder

101
Q

uro

A

relating to urine

102
Q

itis

A

inflammation

103
Q

lithiasis

A

formation of calculi

104
Q

stomy

A

an artificial opening made into an organ through surgery

105
Q

ectomy

A

surgically remove

106
Q

scopy

A

to look or examine

107
Q

fistula

A

an abnormal connection between an organ and another structure

108
Q

rrhea

A

flow or discharge

109
Q

uria

A

in the urine

110
Q

GERD

A

gastroesophageal reflux disease. caused by weakened lower sphincter or increased abdominal pressure

111
Q

findings with GERD

A

heartburn, regurgitation, dysphagia, often aggravated by lying down relived by sitting up antacids, eating, and mid epigastric pain with palpation

112
Q

peptic ulcer disease risk factors

A

H. Pylori, NSAIDS, ASA, corticosteroids

113
Q

peptic ulcer disease findings

A

burning pain in the LUQ/epigastric anywhere from 1-4 hours after eating

114
Q

diverticulitis

A

inflammation of the diverticula. infectious

115
Q

diverticulitis findings

A

increased temp, abdominal discomfort, bowel pattern alterations

116
Q

hiatal hernias

A

stomach protrudes through esophageal hiatus in diaphragm

117
Q

hiatal hernia findings

A

heartburn, regurgitation, dysphagia

118
Q

crohn’s disease

A

mouth to anus. looks like cobble stones (called skip lesions)

119
Q

clinical manifestations of Crohn’s disease

A

severe abdominal pain, cramping, diarrhea, blood or mucus in feces, constipation

120
Q

ulcerative colitis

A

most common form of IBD, happens in colon. mucosa ulcerated. can progress to colon cancer.

121
Q

what can cure ulcerative colitis

A

total colectomy

122
Q

diseases of liver

A

hepatitis A,B,C and cirrhosis

123
Q

hepatitis A

A

usually food-borne

124
Q

hepatitis B

A

uncommon secondary due to immunization

125
Q

hepatitis C

A

common. often undiagnosed, sometimes it doesn’t effect liver enzymes profoundly, leading cause of cirrhosis and liver transplant

126
Q

steatohepatitis

A

fatty liver

127
Q

cirrhosis

A

associated with alcohol intake. associated with malnutrition and vitamin B deficiency, alterations in CBC, coagulopathies

128
Q

coagulopathies

A

blood’s ability to coagulate (form clots) is impaired

129
Q

CBC

A

complete blood count

130
Q

ascites

A

fluid accumulation associated with liver disease

131
Q

cholecystitis with cholelithiasis

A

gallstones

132
Q

gallstones

A

obstruction of the bile duct

133
Q

cirrhosis findings

A

had palpable liver, ascites, jaundice, cutaneous spider angiomas, dark urine, tan stool, splenomegaly

134
Q

risk factors for gallstones

A

female, fat, flatulent, forty

135
Q

gallstones clinical finding

A

RUQ colicky pain that can radiate to right shoulder, indigestion, mild jaundice, nausea after eating high fat foods

136
Q

pancreatitis

A

inflammation of the pancreas which causes auto digestion

137
Q

primary cause of pancreatitis

A

alcohol, gallstones, pregnancy, prior pancreatitis

138
Q

clinical findings of pancreatitis

A

sudden onset, LUQ can radiate to back, chronic, pain is deep, piercing, and heavy, weight loss, steatorrhea, tender abdomen, ascites, jaundice, hypotension, internal bleeding, shock, patient in fetal position

139
Q

pyelonephritis

A

fever, flank, pain, dysuria, nocturia, and frequency

140
Q

UTI clinical findings in older adults

A

fatigue, muscle aches, abdominal pain, shaky and weak, confusion, and delirium

141
Q

clinical findings of UTI

A

frequency and urgency, dysuria, pyelonephritis

142
Q

nephrolithiasis

A

kidney stones

143
Q

risk factors for kidney stones

A

urinary stasis and infection

144
Q

clinical findings of kidney stones

A

fever, hematuria, severe pain at costovertebral angle

145
Q

types of bones

A

short, flat, irregular, long

146
Q

compact bone

A

forms the shaft and outer layer

147
Q

cancellous bone

A

makes up the ends and center

148
Q

tendon

A

muscle to bone

149
Q

ligament

A

bone to bone

150
Q

fascia

A

band or sheet of connective tissue, primarily collagen, beneath the skin that attaches, stabilizes, encloses, and separates muscles and other internal organs.

151
Q

function of cartilage

A

decrease friction

152
Q

synovial

A

freely movable

153
Q

nonsynovial

A

immovable

154
Q

types of joints

A

hinge, gliding, and ball and socket

155
Q

function of the joints

A

provide mobility to the skeleton

156
Q

diathroidial

A

moveable joint

157
Q

bursa

A

fluid filled sac that can form with friction

158
Q

how many cervical vertebrae do we have?

A

7

159
Q

how many thoracic vertebrae do we have

A

12

160
Q

how many lumbar vertebrae do we have

A

5

161
Q

inversion

A

sole of the foot towards the median plane

162
Q

eversion

A

sole of foot away from the median plane

163
Q

protraction

A

anterior movement

164
Q

retraction

A

posterior movement

165
Q

opposition

A

movement of thumb towards a finger or palm to grasp something

166
Q

ottawa fracture rules

A

if you can walk the ankle its probably no broken

167
Q

if joint is not aligned it may be

A

dislocated

168
Q

what does obesity do to the joints

A

puts extra strain and stress on the joints, which can increase the risk of degenerative joint disease

169
Q

if someone has a problem with there left side, what side would you look at first

A

right to get a feeling of what normal looks like

170
Q

what do you asses when a patient ambulates

A

do their arms swing? assess their gait

171
Q

strength scale

A

0/5 strength- none, 1/5 strength- trace, 2/5 strength- poor, 3/5 strength - fair, 4/5 strength - good, 5/5 - full

172
Q

line between iliac crests crosses what spinous process

A

L4

173
Q

what spinous process is at the bottom of you scapula

A

T7

174
Q

which part of your spine should curve posteriorly

A

thoracic and sacral

175
Q

which part of your spine should curve anteriorly

A

cervical and lumber

176
Q

Scoliosis and who gets its?

A

side-to-side spinal curves. On an X-ray, the spine of an individual with scoliosis looks more like an “S” or a “C” than a straight line. scoliosis runs in families. it usually develops in childhood but can occur in adults and elderly.

177
Q

radiculopathy

A

referred pain. pain that is causing/radiating somewhere else

178
Q

herniated disk

A

Normal wear and tear over time can cause one of the disks in your spine to rupture also called a “slipped” disk. Compression or inflammation of the sciatic nerve causes sciatica — a sharp, shooting pain in the lower back, buttocks and leg.

179
Q

what is sciatica hard to diagnose

A

each nerve has a sensory portion for skin sensation, pain, and muscle feedback. There is also a motor portion for muscle control and strength. This adds to the complex nature of diagnosing sciatica

180
Q

vagus

A

knocked knees and usually obese

181
Q

varus knees

A

bowed and usually skinny

182
Q

Ballottement

A

physical exam of knee: With the patient supine and the knee extended, press on the quadriceps muscle just above the knee with one hand and keep that pressure there. Palpate the patella with the other hand feeling for fluid.

183
Q

effusion

A

fluid on the joint

184
Q

Bulge Test

A

physical exam of knee: Differentiates soft tissue swelling from accumulation of fluid behind the patella.

185
Q

Drawer Sign

A

With patient supine flex the knee to a right angle. While standing at the at the patient’s feet, grasp the leg just below the knee and see if you can move it toward and away from self

186
Q

some abnormal findings with MSK

A

TMJ dysfunction, gout, OA, RA, osteoporosis, sprains, fractures, injuries

187
Q

TMJ

A

temporalmandibular joint. permits chewing and speaking, protraction and retraction, and gliding from side to side

188
Q

gout

A

form of arthritis caused by excess uric acid in the bloodstream. mostly in men. strongly correlated with alcohol, obesity, HTN, diuretic use

189
Q

osteoarthritis

A

hard contender nodules. can be heberden’s or Bouchard’s nodes

190
Q

risk factors of osteoarthritis

A

inactivity, overactivity, obesity, repeated injuries, being over 45

191
Q

Heberden’s nodes

A

Osteophytes of the distal interphalangeal joints

192
Q

Bouchard’s nodes

A

Osteophytes of the proximal interphalangeal joints

193
Q

osteoporosis

A

Decreased bone mass. old bone is not replaced as fast with new bone. Bones become weak, spongy and can break easily. osteoporotic bone looks more porous

194
Q

risk factors for osteoporosis

A

woman, caucasian or asian, family history, decreased weight, smoking/drinking, steroids

195
Q

what is the screening for osteoporosis?

A

the Dexa scan

196
Q

how can osteoporosis cause back pain

A

If you have osteoporosis, daily lifting and other routine activities can cause low back pain by fracturing the front part of the weakened bones, these are known as compression fractures

197
Q

rheumatoid arthritis

A

(RA) autoimmune, lab diagnosis, hereditary

198
Q

kyphsis

A

hump back

199
Q

lordosis

A

A curving inward of the lower back

200
Q

who has the highest risk of developing problems from loss of bone density

A

caucasian woman

201
Q

what do you do during the acute phase (such as fall or injury)?

A

assess first! do not move them! unless CPR is needed

202
Q

left hip fracture dislocation

A

Affected extremity exhibits external rotation and is short compared to the unaffected leg. pain will occur when rotating the leg

203
Q

tinel’s test

A

physical exam of hand: Evaluates for carpel tunnel syndrome. Percuss lightly over the median nerve located on the inner aspect of the wrist.

204
Q

phalen’s test

A

Evaluates for carpel tunnel syndrome. Flex wrists 90 degrees and hold the backs of the hands to each other for 60 seconds.

NURSING School (17 decks)

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